Ashley A.

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Hey Everyone,

I hope everyone is doing well.
I wanted to give a quick update. My surgeons office finally received the official approval letter last week so the revision surgery is scheduled for 6/20/12. I'm really excited to be starting this new journey. I decided to create a youtube channel and will be documenting my journey through videos. I posted my first video tonight, I didn't realize how monotone my voice sounds when its recorded..lol I need to work on that.. I'm not sure how to post it here but the link is below if anyone is interested in watching. I will post more of an update next time. Have a great week everyone!

http://www.youtube.com/watch?v=JoE-V3eyCNk
 

Hey everyone,

I hope everyone is doing well..

I just wanted to give an update, on Friday I called my surgeons office to find out if they received the approval letter yet with both codes showing approved, they advised they didn't.
I called the insurance company and spoke with a representative to ask if they could fax over the approval letter. He then checked in the system and stated the 2nd procedure code is still under review and my physicians office needs to call them! WTF!? I had been told by 3 people previously that both procedures had been approved and I told him this and he just said he didn't know why they said that. I called the surgeons office and asked for them to call.
The person I spoke with at the insurance called me later on and advised that he spoke with his supervisor and that in fact both procedures were approved. At that point I was frustrated and just gave up for the day.
Luckily, my surgeons office ended up calling and was told it was approved and was told that the approval letter would be faxed, the surgeons office said a tentative surgery date would be May 18th..but I told them that was too soon so I would like to wait until June. Hopefully they received the approval letter and will be calling me on Tuesday to schedule a definite date. I did end up receiving the denial letter for the sleeve on Friday 5/4 in the mail, this was the decision that was made on 5/1. They supposedly approved the sleeve officially on 5/2 but I have yet to see the letter. I thought I would have received in the mail by now. I will keep everyone posted on what happens.
I hope everyone had a great weekend and has a great week ahead!! Thanks for reading.

Hi Everyone,

I hope everyone is having a great week!

I received an automated call from my insurance today and it said I had an inpatient treatment scheduled and wanted to give me additional information. This was left on my voicemail which I thought was strange so I immediately called the insurance to find out what it was about. The customer service representative checked the the Pre-Certification manager and she advised that both procedures had been approved. The lap band removal and the vertical sleeve gastrectomy were both approved as of today 5/2 so my timing was perfect!
 I then called my surgeons office and they told me yesterday they received a fax saying the lap band removal was approved but the sleeve was denied. At that point I was freaking out because I was so excited when they told me I was approved. The reason for the denial on the Sleeve was due to my BMI only being 39.5 at the appointment the surgeon and I discussed the revision but at the time of insurance submission it was 41.5 so they were waiting to hear back from the insurance company. So I decided to called the insurance Pre-Certification line directly rather than the customer service just to make sure and they stated both procedures were approved and there isn't any denial in their system. As of right now, my surgeon's office won't schedule until they receive the official approval letter, which is supposed to be sent out today. I'm praying the insurance didn't provide wrong information but I spoke with 2 different people so I'm feeling pretty confident they are correct. I will keep everyone posted on what happens! Take Care guys!